Dr. Paul Farmer is one of the most extraordinary people I've ever known. Partner to the Poor recounts his relentless efforts to eradicate disease, humanize health care, alleviate poverty, and increase opportunity and empowerment in the developing world. It will inspire us all to do our parts.
          -William J. Clinton

Pre-order your copy on Amazon.com today!

For nearly thirty years, anthropologist, physician, and PIH co-founder Paul Farmer has traveled to some of the most impoverished places on earth to bring comfort and the best possible medical care to the poorest of the poor. Driven by his stated intent to "make human rights substantial," Paul has treated sufferers of HIV/AIDS and drug-resistant tuberculosis in Haiti, Peru, Siberia, and Rwanda. Throughout his career, Paul has written eloquently and extensively on these efforts.

Partner to the Poor collects his writings from 1988 to 2009 on anthropology, epidemiology, health care for the global poor, and international public health policy, providing a broad overview of his work. It illuminates the depth and impact of Farmer's contributions and demonstrates how, over time, this unassuming and dedicated doctor has fundamentally changed the way we think about health, international aid, and social justice.

Partner to the Poor will be published on April 21. Pre-order your copy today from www.amazon.com. A portion of the proceeds will benefit PIH's work around the world.

Oprah Winfrey's  O: The Oprah Magazine recently selected Partners In Health (PIH) as one of ten organizations to benefit from the magazine’s Live Your Best Life Walk, to be held on Mother’s Day—May 9—in New York City.

The Live Your Best Life Walk was organized to commemorate O Magazine’s tenth anniversary. Over 30,000 walkers and fundraisers are expected to be on hand, along with a variety of television and musical personalities, including PIH Medical Director Joia Mukherjee.

Walkers are encouraged to use the walk as a chance to fundraise for one of Oprah’s favorite nonprofit organizations, including PIH. All funds raised on PIH’s behalf will help support our programs in Haiti.

“Mother’s Day is not only an important occasion to recognize the strength and love of mothers across the globe, but also a time to reflect on mothers and children in need,” said Joia Mukherjee, who will be representing PIH at the walk. “On May 9, we will walk, sing, and come together to show our support, in solidarity and great hope, for the mothers of Haiti and all her people ”

Learn more about the Live Your Best Life Walk and how you can participate.

Last month, we shared an inspiring story about helping earthquake survivors literally get back on their feet. A partnership between Partners In Health and Hôpital Albert Schweitzer provided prosthetic devices to patients who had sustained injuries requiring leg amputations.

Staff at Partners In Health and our Haitian sister organization Zanmi Lasante reported that the patients were able to stand with the help of parallel bars shortly after receiving their prostheses, and promised that they would soon be dancing.

Watch a video to see how these patients are doing today:

When the NYC-based theater group Living Newspaper opened Nou Se Zanmi Benefit, Haitian Creole for “We Are Friends,” recently at Joe’s Pub in lower Manhattan, they did it by singing a Haitian song of mourning, Fèy-o:

“The piece deals with the devastation of the earthquake, but in the beginning and in the end, we returned to the powerful Haitian song, ‘Fèy-o,’ which PIH doctor Evan Lyon first taught us,” says Living Newspaper’s director, Laura Savia.

“We teamed up with an amazing group of drummers trained by Haitian Master Drummer Frisner Augustin, of the New York based La Troupe Makandal,” says Savia. “Our idea is to celebrate the strength and beauty of Haiti culturally and spiritually through dance, drumming, and music, rather than present a solemn, mournful benefit show on the whole.” 

Nou Se Zanmi.

The group–comprised of 3 writers and 8 actors–dramatize current news stories through both live performance and digital webisodes.

“[The idea] is based on the Living Newspaper Unit of the Federal Theatre Project in the late 1930s, which was a political theater group that employed many influential artists and used cutting edge technology to deliver their work to a wide multi-city audience,” says Savia.

“It seemed like a natural fit to bring in a group like ours that does only topical theater for a benefit that is about a topic that has been so prevalent in the news...Hopefully we rallied some troops, some awareness, and some long term commitments of support.”

Both The Living Newspaper and Joe’s Pub have a long history of supporting Partners In Health’s work in Haiti. “We have the opportunity through this performance not only to raise awareness about Haiti and about PIH, but also to offer lasting images of hope and strength—ones not always shown on the news,” says Savia. “If every theater company participating—and every individual attending—could leave as an ambassador for Haiti and for PIH, the ripple of awareness in the arts community here would be extroardinary.”   

The shows producers are planning to air footage of the benefit online as a way of encourage people to continue donating to Partners In Health’s STAND WITH HAITI campaign.

Nou Se Zanmi brings together some of the most exciting young theater companies and artists in New York City, creating a tapestry of new songs and scenes, all responding to recent events in Haiti.

The benefit featured the work of various groups, including: At Play Productions, The Coterie & Matt Gould, EST/Young Blood, Hoi Polloi, The Living Newspaper, Loki, The Movement Theatre Company, New Georges, New York Neo-Classical Ensemble, and The Subjective Theatre Company.

All proceeds from the evening benefited Partners In Health.

Listen to a choral version of Fèy-o as sung by a choir at St Peter’s College Chapel, Oxford.

Teodulfo Blaas at work.

Teodulfo Blaas, a Peruvian restaurant owner, is in an unlikely position in today’s economy. While other entrepreneurs have seen business slow and even halt, Teodulfo’s business is thriving to the point where he is now considering opening a second location.

But just a few years ago, Teodulfo was in a very different situation—he had been diagnosed with multidrug-resistant tuberculosis (MDR-TB), a life-threatening disease that until recently was considered incurable in resource-poor settings like Peru. After about two years of intensive treatment, Teodulfo was cured, but the illness and the side effects of his medications forced him to leave his job as a laborer. This left the father of five with no income and with no prospects in Lima’s tight labor market.

The only viable option seemed to be to start his own business, but Teodulfo was far from an ideal candidate for a typical microenterprise program. His scant resources and recent health history made him seem like a risky investment. Even if he found a bank to loan him some capital, he didn’t have any business experience to speak of.

Fortunately, this atypical microenterprise candidate met an atypical microenterprise program in Socios en Salud (SES), PIH's Peruvian sister organization. Initiated with the assistance of the organization Nexos Voluntarios, the project provides small loans (generally between $300 and $700) to former patients, people who would not qualify for traditional loans because of their health status. SES's program requires no formal collateral and relies instead on the trusting relationships patients had built with SES staff over their years of treatment. Even more importantly, the program provides intensive, ongoing business training to patients who have little or no experience. This training includes several weeks of business seminars and individual mentorship to develop their business plan leading up to the loan, and then ongoing mentorship through monthly visits by loan officers during the life of the loan. SES made one final change to the standard micro-enterprise model: after recognizing that patients generally draw from basic needs like food or education to pay interest on their loans, they decided to provide the loans interest-free. Since this first class of twenty loan recipients, the program has expanded to over one hundred and twenty participants. In addition to MDR-TB patients, recipients now include HIV patients, and the family members of patients where appropriate (e.g. if the patient is a small child).

Teodulfo was part of the first class. Drawing on a job he once had as a cook in a Chinese restaurant, he decided to open his own small restaurant, serving up Chinese food with a Peruvian flare, such as aeropuerto (“airport”), a fried rice dish with local vegetables.

The intensive business training introduced him to basic financial concepts and helped him develop a business plan. His loan proposal was approved and an SES employee accompanied him to buy the startup supplies he needed. He then received monthly visits from an SES mentor/loan officer who would collect his payment and discuss the state of the business. Since its opening, the business has grown steadily and the biggest problem now is finding enough space to seat everyone during the night-time rush.

Watch a recent PBS Newshour video report highlighting another SES microenterprise success story – Oscar Ccencho Huamani, recovered MDR-TB patient and candystore owner.

Marumo Marumo, the Traditional Birth Attendant (TBA) Coordinator, with four TBAs at a recent training.

In the small southern African country of Lesotho, about one out of every four adults is HIV positive, and high rates of maternal mortality and morbidity threaten the country’s young mothers. The rough, mountainous terrain and lack of roads exacerbates the situation, preventing many people from easily accessing the medical services needed to curb the epidemics.

To help address these problems, Partners In Health Lesotho (PIHL) is using traditional birth attendants (TBA)—local traditional midwives—to provide women living in rural mountain villages with access to comprehensive services including HIV testing, counselling, and treatment; methods of preventing HIV transmission from mother-to-child; and antenatal (prebirth), delivery, and general post-birth health care; immunizations; as well as general reproductive health services.

In May 2009, PIHL, in partnership with the Elton John AIDS Foundation, began to pilot a TBA program in a catchment area that includes 71 villages around PIHL’s health center in Bobete. PIHL hired and trained 100 local women to serve as a link between the clinic and pregnant women—who are literally their neighbors. The TBAs locate and accompany the expectant mothers through their pregnancy and birth to ensure that they have full access to the clinic’s comprehensive services. This includes bringing the women to the clinic to deliver their babies.

The TBAs are a part of Lesotho’s traditional midwifery community and PIHL seeks not to replace them, but to further their education and employ them in an expanded role as community health workers in the communities of which they are already a part. And as families traditionally pay TBAs for delivering babies, the PIHL program provides a cash incentive for each woman a TBA accompanies, replacing the income lost when women choose to deliver at the health center.

In the first six months of the project, the TBAs completed their training, surveyed their villages, and began to visit pregnant women in their homes. They accompanied 172 women to the clinic for antenatal care, and accompanied 53 women to deliver at the clinic. Clinic deliveries have steadily risen in response to TBA outreach, with at least 24 women giving birth at the health center last month.

The advantages of delivering in the Bobete clinic are significant, particularly in preventing the transmission of HIV during childbirth. Delivering with the assistance of a skilled nurse decreases the risks of maternal mortality and morbidity, and infants with health issues can receive immediate medical attention.

To enable more women to deliver at the health center, PIHL is renting waiting houses near the clinic that can shelter six women at a time. Rough terrain separating the remote villages from the health center can make the journey virtually impossible for a woman with labor complications, so these houses make it possible for women to make the journey before labor begins.

As an extra incentive, PIHL also provides new mothers who fulfil certain criteria (get tested for HIV, attend at least three antenatal visits and deliver their baby at the clinic) with a new baby package, which includes clothing (hat and sweater), pins, and a bathtub. During the programs first six months, PIHL distributed 60 new baby packages.

PIHL believes that the accompaniment of the TBAs and the general knowledge and care delivered during the antenatal visits will encourage each woman to deliver her baby at the clinic, and that in doing so families in the Bobete catchment area will see a decrease in HIV mother-to-child transmission rates, as well as maternal and infant mortality and morbidity rates. In the coming year, the PIHL team hopes to expand this program to six more rural health centers.

“In the streets and resettlement camps of Port-au-Prince, the promises and rhetoric were greeted with a healthy dose of skepticism,” writes Partners In Health’s (PIH) Medical Director Dr. Joia Mukherjee in an April 7 editorial, “Promises, Promise—What It Will Take to Rebuild Haiti.” The piece was published on the online news site The Huffington Post.

The editorial addresses promises made at last week’s International Donors’ Conference Towards a New Future for Haiti, hosted by the UN at its headquarters in New York City. The conference demonstrated an international commitment to Haiti’s short and long-term recovery and yielded pledges totaling more than $9.9 billion USD for Haiti’s reconstruction, governance, and broad-based sustainable development.

“The amounts pledged to support relief and reconstruction at the March 31 International Donors’ Conference for Haiti were impressive,” writes Joia, “So was much of the accompanying rhetoric about recognizing Haitian leadership and empowering the Haitian people.”

“Nearly three months after the January 12 quake, the scene remains grim. An impoverished city of three million people—long without adequate building codes, sanitation or waste management—has been reduced to a patchwork of ruins and fetid shanty settlements. As the first torrents of the rainy season pour down and the hurricane season looms, hundreds of thousands of people live in makeshift shelters with little or no access to sanitation, many on slopes where they could be swept away by mudslides, others on patches of low-lying ground that will inevitably become a toxic stew of mud, garbage, and human waste. Children remain out of school and the medical infrastructure of Port-au-Prince lies in ruins.”

To read Joia’s perspective on what it will take for Haiti to win the struggle for dignity, and what changes need to occur before Haiti’s people can rebuild their country, click here.

	Tom White visiting Haiti in the early days of PIH's work in Cange.

On March 10, 2010, PIH celebrated the 90th birthday of PIH’s co-founder and partner, Thomas J. White. For many years, Tom has enabled PIH to do “whatever it takes” to make our patients well. Millions of lives have been saved around the world because of it. Whether financing the construction of a small clinic in Cange or investing in the expensive drug regimens of PIH’s first multidrug-resistant tuberculosis (MDR-TB) patients, Tom’s investment in service to the destitute sick and his vision of what could be has changed global health delivery forever.

PIH’s facility in Cange has grown from a one room clinic to a fully functional hospital with inpatient, outpatient, surgical, and specialized care available to patients regardless of their ability to pay. It is a symbol of hope for the poor throughout Haiti. Similarly, MDR-TB is no longer a death sentence in resource poor settings—that initial cohort of Peruvian patients treated with Tom’s investment helped us prove that the disease could be cured, which in turn helped to change global policy.

To understand Tom’s passion, motivation, and drive to help the poor throughout his life, it is best to read his own words. In an autobiography, he writes:

I think it’s important for us to live in an inclusive world. Excluding people for this reason or that is, in most cases, grossly unfair. I also think that that the myth of the self-made man is exactly that, a myth. All of us are born under many conditions over which we had no control or no vote, i.e. where and when we were born, whether we were male or female, the color of our skin, our ethnicity, and our religion.

... In speeches that I have had to give in the last three or four years when I was the honoree of certain organizations at their annual dinner, I have always tried to emphasize the following message: - three things – 1) Don’t be apathetic – be involved, 2) Live your life, at least in part, for other people, 3) Realize that there is an urgency to your giving, especially if you are giving to the poor.

At this milestone in Tom’s life, we take pause to recognize the importance his ongoing support of PIH and of all the suffering people and communities around the world. We honor Tom, sharing with you the words and reflections of his closest partners in these efforts—the other four PIH co-founders:

	Tom White with Paul Farmer at a recent event.

Now we face our greatest challenge, ever, in Haiti—our house, laid in ruins. But thinking about Tom and his light, which will never be extinguished (because a light so displayed cannot be extinguished), allows us to move forward with conviction and some experience. This, then, is our birthday present to him: all of those whose work Tom has supported will pull together to amplify that light and shine it on those in the greatest need.
          -Paul Farmer

The countless people whose lives have been transformed by Tom’s heart and soul are a testament to his nine decades on this earth. Everywhere I go I meet people whose eyes light up when his name is mentioned because of his conviction that everyone deserves to have a shot at a decent life.
          -Ophelia Dahl

My mother has always said that the only true saint she has ever met is Thomas J. White. As a trained theologian, I'm convinced that my mother knows what she's talking about. Tom is the only person I know who, even without witnessing the suffering of the poor every day, truly ‘suffers with’ them every moment of his life. Tom has been a huge moral presence in my life and is ever present in my consciousness through his namesake, my older son Thomas J. Kim.”
          -Jim Yong Kim

Tom has done so much to help so many people, and I count myself as lucky to be one of them.
          -Todd McCormack

We invite you to share with us how Thomas J. White—his philosophy and action—has inspired you to make a difference in the world. Please visit http://act.pih.org/tj-white-inspired.

Earthquake survivor Zilania Jaocim begins her long journey.

On March 28, Zilania Jaocim finally left Haiti after suffering in excruciating pain for 11 long weeks, on a plane bound for Boston. As the treatment she needed could not be performed in her own country, Partners In Health’s Right to Health Care Program helped arrange for a medevac. But this was just the final leg in her journey to find treatment.

Mrs. Jaocim's home in Port-au-Prince collapsed on her and her husband, Reserve Coffy, during the January 12 earthquake, trapping the couple in a small backroom. While Mr. Coffy escaped serious injury, Mrs. Jaocim, a 67-year-old diabetic, was struck by falling debris. Her leg was crushed.

The couple’s son, Jean Paul Coffy, could not find any news about his parents following the quake. Distraught, he flew from Chicago to Haiti to search for them. He finally found them at their home, alive but too weak to escape to safety.

After digging them out, Jean Paul drove his parents to the Dominican Republic for medical attention. For weeks they were in and out of different facilities. The problem: Mrs. Jaocim’s hip was infected. Surgeons could not operate on the leg until the infection subsided and swelling decreased. Her physician in the Dominican Republic estimated that she would have to wait three months before having surgery.

The family quickly realized that this option was dangerous to Mrs. Jaocim’s health. They had to do something more. Jean Paul Coffy started a blog to raise money for his mother’s hospital bills—not to mention the cost of his taking off work and traveling to Haiti.

The family eventually contacted Partners In Health (PIH) in Boston looking for help. After learning of their situation, our colleagues in Haiti arranged to transport the family to our hospital in Cange for medical care. But shortly after Mrs. Jaocim had been admitted, PIH staff recognized that her medical needs would exceed the level of care realistically available in Haiti at this time. Dr. Koji Nakashima assessed Mrs. Jaocim’s situation. He knew she needed to be moved out of the country if she was going to survive.

It is here that the family’s luck changed again for the better. Visiting Cange at that time were both the President of Brigham and Women’s Hospital (BWH) in Boston, Dr. Elizabeth Nabel, and Partners HealthCare President Dr. Gary Gottlieb. After meeting the couple, they helped arrange for Mrs. Jaocim to receive free treatment at BWH. The PIH team raced to secure travel documents and make travel arrangements, and on March 28, the couple took off for Boston.

Dr. Nakashima, who accompanied the couple on the medevac, recounted the trip:

	Ms. Jaocim flew on a medevac plane out of Port-au-Prince.
	Ms. Jaocim and her husband reunite with their son, Jean Paul Coffy, at Brigham and Women's Hospital in Boston.

We left the medicine ward in Cange around 9 a.m.

A short ride up to Savanette led us to a helicopter-landing zone that we had plotted out by GPS the night before.  

Thanks to the generous support of the World Food Program, a helicopter saved Zilania yet another bone grating ride along Haiti's rocky roads, bringing us to the United Nation’s Logbase, located in Port-au-Prince.  

There we were met by an ambulance donated and crewed by staff from Sweden, who delivered us to the airport with a gentle hand.  

We were also met by PIH’s PAP-based staff with the couple’s Humanitarian Parole papers, the product of a network spanning from Boston to Haiti.  

Reserve marveled at the airplanes shuttling the innumerable volunteer teams.  He said, ‘I counted 47 people leaving to that plane, can they all fit?’ he asked.  I pointed to a Boeing 737, ‘That can hold 300 people.’

But we were waiting for our air ambulance, made possible by Erik Bartkowiak from Global Aeromedical and Lance Letchworth from Jet Fleet International, who volunteered their time and provided their service at cost.  

Zilania slept most of the way to Medford, MA, a testament to the kind care of Erik and Lance, as well a restful mind.  

In Medford, we were welcomed by a Fallon ambulance, PIH’s Right to Health Care team, and Jean Paul Coffy, the couple’s son.  

‘This has been the hardest experience of my life,’ Jean Paul confided to me, ‘But now I feel like I won the lottery.’

PIH staff both in Boston and in Haiti are excited to report that Mrs. Jaocim is safe and comfortable at BWH.

The family’s saga was given national coverage in two New York Times stories, the first published while they were still languishing in the Dominican Republic and the other after they arrived happily in Boston.

The PBS series FRONTLINE recently aired The Quake, an investigation into the efforts of those responsible for handling the catastrophic January 12 earthquake in Haiti. Correspondent Martin Smith bears witness to the unprecedented scale of the disaster and takes viewers on a searing and intimate journey into Port-au-Princes’ spontaneous settlements, hospitals, and broken neighborhoods in this hour-long documentary.

The Quake questions Haiti’s prospects for real change during this pivotal period, drawing on interviews from a number of experts, including PIH co-founder Paul Farmer; Louise Ivers, PIH’s Clinical Director for Haiti; and PIH physician David Walton.

“This is an opportunity to rethink how aid works and how we, the most powerful country I this part of the world, can work with our oldest neighbor,” said Dr. Farmer. “So I think all that possibility is build into this tragedy.”

Watch The Quake on the player below:

As of last week, donations for earthquake relief for Haiti have surpassed $2.5 billion, with another $1.2 billion pledged, according to UN reports. But this money has yet to improve the conditions on the ground for hundreds of thousands of desperate survivors. Watch the video below to learn more:

As representatives from wealthy nations gathered at the United Nations for a Donors' Conference to pledge support for rebuilding Haiti, the importance of ensuring that donations translate into adequate shelter, food, and clean water becomes more vital.

Make a pledge to STAND WITH HAITI in the months and years ahead. Sign the petition.

The 2010 Global Health Delivery Fellows.

From implementing a PIH project high in the rural mountains of Lesotho in southern Africa to directing a rural health center in Haiti to studying as a Fulbright scholar in the U.S., accomplishments and a record of leadership distinguish this year’s Global Health Delivery Fellows.

In the midst of the tragic aftermath of the January 12 earthquake in Haiti, there was a bright spot that indeed shone hope and promise on the future of Haiti. On February 27, 2010, Partners In Health (PIH); the Brigham and Women’s Hospital (BWH); Harvard Medical School (HMS); Zanmi Lasante (ZL); and the Haitian Ministry of Population and Public Health (MSPP) held the first convocation for the joint fellowship in Global Health Delivery. Twenty physicians were honored for completing “academic training and credentialing in the delivery of health care while strengthening the public sector in resource poor settings.”

The fellowship program in Global Health Delivery is a program jointly administered by the BWH’s Division of Global Health Equity (DGHE), HMS, MSPP, and PIH and ZL.  The program was designed to train a cadre of Haitian physicians to implement and deliver programs to treat HIV and TB while improving the primary health care system within the public sector.

The three-year fellowship includes training in the use of HIV therapy; case detection and treatment of TB and other opportunistic infections; treatment of malnutrition; and innovative practices in delivering primary health care in resource-poor settings. Fellows are also mentored, “shoulder to shoulder,” by faculty at the DHGE in locations supported by ZL and the MSPP.

This graduation, held on the grounds of the PIH/ZL Socio-Medical Complex in Cange, Haiti was the first of its kind anywhere in the world. The Global Health Delivery fellows were awarded certificates for working within public structures in countries with PIH-affiliated hospitals and clinics, including Burundi, Haiti, Lesotho, Malawi, Peru, and Rwanda.

The 2010 class of fellows – with more than 150 years of clinical experience between them – is the first to receive this honor. 

Dr. Maxi Raymonville

With music provided by the Cange church musicians, speakers referenced the struggles endured not only by the fellows, but also by Haitians more broadly. Dr. Maxi Raymonville, the laureate with the most years (19) of PIH/ZL service, focused mainly on the durable philosophy he learned in Cange. “Together, our goal is to reach the poorest, the most isolated, [those in] the toughest situations and individuals in suffering and to provide care,” he said. Read other remarks and speeches made at the convocation.

Speaking in Kreyol, with Dr. Farmer translating, PIH Executive Director Ophelia Dahl praised the graduates for their accomplishments, observing how “the road to justice is long and paved with thorns.” Now there is a bridge, she said, but only after many years of work and effort to build new partnerships, and it stands as a testament to ZL’s dedication. “This graduation was planned long before the earthquake, and was a moving tribute celebrating the extraordinary contributions our Haitian colleagues have made to improve the lives of so many,” said Dahl.

But this hopeful convocation was also, appropriately, a memorial. Two fallen collegues were honored and posthumously awarded fellowships – Dr. Josue Augustin, ZL Chief of Surgery, who was murdered in August, 2009; and Dr. Mario Pagenel, ZL Director for Training and Medical Education and the Director of the Caribbean HIV/AIDS Regional Training Center , who died in the January 12, 2010 earthquake.  

“Dr. Pagenel truly lived the term preferential option for the poor,” said PIH’s Clinical Director in Haiti, Dr. Louise Ivers. “He could have worked anywhere but he decided to work in one of the most isolated parts of Haiti to serve his people.

Also included in the ceremony were Dr. Gary Gottlieb, President and CEO of Partners Health Care and PIH board member; Dr. Betsy Nabel, the President of the Brigham and Women’s Hospital; Dr. David Golan, Dean for Graduate Medical Education at Harvard Medical School; and Mr. Rick Mills, Dean of Global Health Programs at Harvard Medical School.

It was an emotional and moving ceremony for many of the honorees, their families, and for those of us who have worked closely with them. In some cases, these working relationships have lasted for more than a decade.

Below are some excerpts from remarks at the convocation: 
 

Dr. Joia Mukherjee with the GHD Fellows.

To accept the whole world as one home and family is to assume that we too have a responsibility to our brothers and sisters, mothers and fathers.  To bear witness to the suffering of others is to allow the truth into our lives; the truth, that our privilege, historically, as today, is connected with systems that perpetuate the cycle of poverty…mize.  And once we open our eyes, heart, mind and spirit to the pain and suffering of the large mass of humanity we call the poor, it is impossible to close them again for even sleep is tormented by facing the abyss between comfort and enormous, inequitable and unnecessary want; the wounds of those who live from day to day without food, water, shelter, without education, without medical care.

The Fellows in Global Health Delivery who we are honoring today are colleagues and friends, brothers; those my son calls ton ton. They are the men whom I have worked with, taught, learned from, travelled with, laughed with and cried with for eleven years. We have together set up a national program for the treatment of multi-drug resistant (MDR) TB in Peru, and public sector programs to improve health care and integrate HIV and TB services in 52 facilities – 11 in Haiti, and 41 in four African countries. The influence of our collective work has been felt in countries throughout Africa, Asia, Latin America and in superpowers like the US and Russia.  These doctors have, here, have made a deep commitment to community-based work, to public sector work, to make a preferential option for the poor….They represent the backbone upon which global health will be taught in the decades to come.

-Joia S. Mukherjee, MD, MPH
 PIH Medical Director
 Associate Professor, Harvard Medical School, 
 Division of Global Health Equity, Brigham and Women’s Hospital

My belief that health is a basic human right embodies my conviction to reduce the barriers that deny health care to the destitute sick….Driven by this conviction, humbly and modestly I lead ZL’s efforts to incorporate interventions for clean water, food support, employment opportunities, housing, and education into the care of patients who are systematically marginalized by grinding poverty.   Because I believe healthcare should be a public good rather than a private privilege, I have committed myself to working through the public sector to deliver care to the poor. Since early 2002 when monies from Global Fund against AIDS, TB and Malaria (GFATM) were awarded to us in Haiti, I have been active in integrating ZL’s support into the government of Haiti’s public health system, as the public system is the only entity that can guarantee the rights of its citizens…we have achieved this through carefully and persistently raising awareness among his colleagues in the Ministry of Health, and by mentoring young clinicians who join the ZL team in the principles of health and human rights.

When Partners In Health was asked by the governments of Rwanda, Malawi, and Lesotho to expand its model of care to their countries, I was among the first members of PIH’s team who led the effort. I started travelling to Rwanda in 2005 to train local doctors and nurses, assuring… them that, based on my experience in Haiti, it was indeed possible to provide primary care and to treat serious and chronic disease in settings of extreme poverty and within the public sector. I quickly had an immediate credibility and a connection with local clinicians and HIV/AIDS association leaders. This Fellowship in Global Health Delivery is the recognition of our work, and the contribution of the Zanmi Lasante model to delivering health care in the world’s poorest settings. 

Today we are paying tribute to the values of engagement, humility, availability, honesty, compassion, vision, and solidarity. These values are embodied by many of the staff who have come through this program, attended hundreds of late night meetings, worked tirelessly in patient care and human rights activism. I will finish in thanking all of you who contributed to making the Fellowship in Global Health Delivery a reality… Paraphrasing Dr Martin Luther King, Jr., “Among all the human rights the lack of access to health care is the most inhumane!”

-Fernet Renand Leandre MD,
 1997-present, Director STI/TB/HIV and Public Sector Partnership, Zanmi Lasante
 2005-present, Chief Consultant for Inshuti Mu Buzima, PIH, Rwanda
 2007- present, Consultant, Village Health Works, Burundi

My first day at Zanmi Lasante, I was greeted by Dr. Maxi and Dr. Leandre and to be honest, I thought they were nuts.  They spoke to me about everything except medicine – such as transport costs, income-generating activities, construction of houses, compensation for community health workers. In fact I stayed lost, I wasn’t even sure they were doctors.  But, I needed to learn, I needed time to live this reality. …(Later) in my first year, I was annoyed, I did not think doctors should do home visits. I remember one of our faculty asked me to go find a TB patient, who had left without finishing his therapy…the attending insisted that any doctor taking care of a patient has a responsibility if the patient leaves the hospital. After returning to the hospital with the patient from the village of Kayi Pin, I began to think differently about the doctor-patient relationship; about how my talking with and spending time with the patient changed his outcome.

We decided to stay in a rural place, not to return to the city, or to do a residency – but to become “Dokte Mon” – a mountain doctor. You must understand, that we were among the best students in our classes in medical school, each of us was expected to do a residency. Generally, those who are called “mountain doctors” are surrounded by rumors of incompetence…but for us, choosing this path is our core engagement to join this determined team, Haitian and foreign, who in a noble mission, serve the Haitian poor. It is not easy to be devoted to this mission, there are sacrifices in these rural places, far from the lucrative and prestigious jobs in the capital that garner a private clinic or a car. But you all have accompanied us to a much greater goal, to see the medicine in a community way, medicine in service to all those who require it…I will summarize key points of our training, concepts that our mentors have inculcated among us

• To work to constantly improve health indicators.
• To disseminate best practices.
• To practice medicine which respects human dignity even in the face of humiliating poverty; poverty in which access to drinking water, food and health represent a luxury.
• The belief that health is a right and that only the state can guarantee that right, that each individual must have access to the health care in regardless of their ability to pay.
• A commitment to working with and for the state as the entity responsible for assuring the right to health.
• A holistic, a comprehensive package, in which the patient is the center of all our interventions.
• The belief in lasting partnerships—in working with the state, we do not set forth an exit strategy. Rather, we accompany the state and the community in a long-term commitment to empower public institutions and communities in the capacity to deliver the benefits of medical technology to the poorest.
• The refusal to accept the medical double standard which is the status quo…where the largest needs are accompanied by the fewest resources which assures that the rich person and the poor person get different treatments.
• The belief that medicine is also a source of development, not only by assuring a health population, but by through job creation at the community level. Our projects are the examples of this approach. In Haiti today, more than 6000 people are employed through the Zanmi Lasante-MSPP partnership. In our work in Rwanda, in less than three months, we trained and employed 200 people. There are many stories like this, stories of transformation.

So, dear colleagues, if this is what it means to be a “mountain doctor” then I congratulate all of you on your title of mountain doctor, and I am proud to be among you.

-Charles Patrick Almazor MD, MPH
 Director of ZL-Public Sector Partnership, Artibonite Department, 2007-2008
 Director IMB-Public Sector Partnership, Burera District
 Fulbright Scholar 2006, MPH University of Alabama, Birmingham

Full list of 2010 Global Health Fellows: 

• Charles Patrick Almazor M.D., M.P.H. – Haiti (2002-06, 2009-present); Rwanda (2007-08);
  Fulbright Scholar, University of Alabama, Birmingham (2006)
  Director IMB-Public Sector Partnership, Burera District (2007-2008)
  Director, ZL-Public Sector Partnership, Artibonite Department (2009-present)
• Junior Bazile M.D., M.P.H. – Haiti (2003-07); Burundi (2010-present)
  Fulbright Scholar, M.P.H., University of Alabama, Birmingham (2008)
  Medical Director, Village Health Works, Burundi (2010-present)
• Renard Cruff M.D. – Haiti (2004-present)
  Director, HIV/TB Program, St Therese Hospital, Hinche, Haiti (2004-present)
• Johny Denis M.D. – Haiti (2007-present)
  Director, Program in Chronic Care, Petite Riviere, Haiti (2007-present)
• Jean Roland Désiré M.D. – Haiti (2004-2008, 2010-present)
  Director, Lascahobas Clinic, Haiti (2005-2008)
  Consultant, Inshuti Mu Buzima, PIH Rwanda (2008)
• Darius Leopold Fenelon M.D. – Haiti (2004-present)
  Director, HIV/TB Program, Thomas J. White Pavillion, Cange, Haiti (2007-present)
• Jaime Bayona Garcia M.D., M.P.H. – Peru (1994-present)
  Director, Socios en Salud, Peru (1994-present)
• Jean-Gregory Jerome M.D., M.P.H. – Haiti (2003-06, 2007-present)
  Fulbright Scholar, M.P.H., Boston University (2007)
  Deputy Director, Monitoring and Evaluation, Zanmi Lasante, Haiti (2007-present)
  Consultant Inshuti Mu Buzima, PIH Rwanda (2007-present)
• Wesler Lambert M.D., M.P.H. – Haiti (1998-present)
  Director, Unité Communale de Santé # 3, Central Department, Haiti (2002-present)
  Director, Monitoring and Evaluation, Zanmi Lasante, Haiti (2006-present)
  Consultant, Inshuti Mu Buzima, PIH Rwanda (2006-present)
• Fernet Renand Leandre M.D. – Haiti (1996-present)
  Director, HIV/TB/STI Program and ZL-Public Sector Partnerships, Zanmi Lasante Haiti (1997-present)
  Chief Consultant, Inshuti Mu Buzima, PIH, Rwanda (2005 present)
  Consultant, Village Health Works, Burundi (2007- present)
• Mario Pagenel M.D. – Haiti (2006-January 12, 2010 – posthumous award)
  Director, Caribbean HIV/AIDS Research and Training Center, Haiti 2009-2010
• Paul Pierre M.D., M.P.H. – Haiti (2004-07); Malawi (2009-present)
  Fulbright Scholar, M.P.H., University of Arizona (2008)
  Director, Community Programs APZU, PIH Malawi (2009-present)
• Jean Aine Pretanvil M.D. – Haiti (2005-present)
  Director of the Thomonde Hospital, Haiti (2007-present)
  Smith Scholar, Harvard School of Public Health and Brigham and Women’s Hospital (2009)
• Anany Gretchko Prosper M.D., M.P.H.-student – Haiti (2005-2009)
  Director, ZL-Public Sector Partnership, Artibonite Department, Haiti (2008-2009)
• Max Raymond, Junior M.D. – Haiti (2006-present)
  Director, HIV/TB Program, San Nicolas Hospital, Saint-Marc, Haiti (2006-present)
• Maxi Raymonville M.D. – Haiti (1991-present)
  Director, Women’s Health, Zanmi Lasante, Haiti (1997-present)
  Chief Consultant, Women’s Health, PIH African Initiatives (2005-present)
• Jonas Rigodon M.D., M.P.H. – Haiti (2002-04); Lesotho (2006-08); Malawi (2009- present)
  Director of Nohana Rural Initiative, Lesotho (2006-08)
  Director, APZU-Public Sector Partnership, Malawi (2009-present)
• Mackinley St Louis M.D. – Haiti (2008)
  Director, Haitian National Referral Center for MDR- TB, Thomas J. White Pavilion, Cange, Haiti (2006-present)
• Ralph Ternier M.D., M.P.H.-student – Haiti (2003-present)
  Director, Belladere Hospital, Haiti (2003-present)
  Chief Consultant APZU, PIH Malawi (2008-present)
  Poorvu Fellow, Division of Global Health Equity, Brigham and Women’s Hospital (2008-present)
  Director, Haiti-Dominican Republic Cross Border HIV program (2009-present)
• Patrick Ulysse M.D. – Haiti (2006-present)
  Director, HIV/TB Program, Petite Riviere, Haiti (2007-present)

Loune Viaud

In recent testimony presented to the Inter-American Commission on Human Rights (IACHR), Loune Viaud, Director of Operations for Partners in Health’s (PIH) Haitian sister organization, Zanmi Lasante, highlighted the importance of ensuring that all post-earthquake relief and development efforts by the hundreds of non-governmental organizations (NGOs) in Haiti be done both in collaboration with the local people and in a way that respects and upholds Haitian’s rights throughout the rebuilding process.

“We have found that the best way to ensure that access to these services are both universal and sustainable is by partnering with Haitian public institutions that are ultimately responsible for ensuring that Haitians can access the right to health, water, food, and education,” said Viaud, “These partnerships ensure that the capacity of the government is enhanced, and that the assets we are creating—crucial infrastructure and services—are ultimately owned by the Haitian people,” she emphasized.

The IACHR is an independent arm of the Organization of American States (OAS)—an international organization that includes thirty-five Member States, all located in the Americas—and is one of two bodies in the inter-American system devoted to promoting and protecting human rights. The organization periodically hears testimony from both NGOs and government entities in an effort to bring potential human rights issues to light for the international community. Recommendations made by the IACHR in the past have influenced international policy.

Because she was accompanying patients being transported to hospitals out of Haiti, Viaud was actually unable to attend the March 23 hearing in Washington D.C. Her daughter, Maureen Plaisimond, delivered her presentation on the economic and social rights situation in Haiti on her behalf. In her testimony, Viaud warned that the international community's efforts could harm already vulnerable communities unless those organizations employ rights-based approaches which support the capacity and leadership of the Haitian government; defer to the experience of Haitians; and unconditionally respect human rights, including the rights to food, health, and potable water.

Viaud’s testimony was accompanied by that of other advocates from prominent human rights organizations, including: the Center for Human Rights and Global Justice (CHRGJ) at NYU School of Law; Bureau des Avocats Internationaux (BAI); the Institute for Justice & Democracy in Haiti (IJDH); and the Robert F. Kennedy Center for Justice and Human Rights (RFK Center). A petition from these organizations resulted in the only Haiti hearing granted during this IACHR session.  To read the organizations’ recommendations to the international community, a document that outlines a rights-based approach to aid delivery, click here. 

The IACHR hearing proceeds the much-anticipated March 31 International Donors’ Conference for Haiti at the United Nations headquarters in New York, where future international aid to Haiti will be discussed at length.

To illustrate camp conditions to the IACHR and the international community at large, the presenters included a short video as part of their testimony:

The New Media Advocacy Project prepared the video for the hearing on behalf of the hundreds of organizations involved in this initiative, including the Institute for Justice and Democracy in Haiti, PIH, and the Bureaux des Avocats Internationaux.

Below is the full text of Loune Viaud's testimony:

Testimony of Loune Viaud 

Delivered to the Inter-American Commission on Human Rights 

During a Hearing on the  Economic and Social Rights Situation in Haiti following the Earthquake and the Human Rights Obligations of OAS Member States 

March 23, 2010 

My name is Maureen Plaisimond.  I am here today to read a statement on behalf of my mother, Loune Viaud, the Director of Operations for Zanmi Lasante, the Haitian partner organization of Partners In Health.  My mother could not be here today, because the right to health care is not being adequately fulfilled in Haiti today and she is helping transport two severely injured children to receive additional medical care in the United States.

On behalf of Zanmi Lasante, I want to thank the Commission members for ensuring the voice of a Haitian woman is heard. I want to tell you about how international assistance has supported our work, and I will also share how such assistance can have—and has had in some cases—a detrimental impact on fundamental economic and social human rights such as access to water, adequate food and healthcare.

Before January 12, Zanmi Lasante already provided comprehensive primary care, regardless of ability to pay, for more than half a million impoverished people in the Central Plateau and Artibonite departments in Haiti.  We employed about 4,000 Haitians, many of them community health workers; that number is now over 5,000 throughout Haiti.  I can list the many services that Zanmi Lasante carries out in the Central Plateau—in collaboration with the Ministry of Health—we support 12 health facilities, including 7 hospitals, in rural Haiti, including a Sociomedical Complex with 104 beds, a full-service hospital with two operating rooms, adult and pediatric inpatient wards, an infectious disease center, an outpatient clinic, a women’s health clinic, ophthalmology and general medicine clinics, a laboratory, a pharmaceutical warehouse, a Red Cross blood bank, and radiographic services. Because health and other basic economic and social rights are so closely related, we have also founded a dozen schools, numerous water projects, and an agricultural project.

All of these services are the fruits of years of our work, but that alone would be insufficient if it was done without ensuring that it is sustainable, that it is really here to stay.  We have found that the best way to ensure that access to these services is both universal and sustainable is by partnering with Haitian public institutions that are ultimately responsible for ensuring that Haitians can access the right to health, water, food, and education.  These partnerships ensure that the capacity of the government is enhanced, and that the assets we are creating—crucial infrastructure and services—are ultimately owned by the Haitian people.

Our partnerships have endured through times of political conflict.  And our partnerships have been especially important in the midst of this disaster.

As one of the largest health care providers in Haiti, Zanmi Lasante has been a central partner in the international community’s response to the earthquake.  Because all of our sites were—before the earthquake—outside of Port-au-Prince, most of our workers were, at least physically, unharmed by the earthquake, though they—like their fellow Haitians—suffered the trauma of losing family members, friends, and homes.

Despite their losses, our staff has been working around the clock to provide medical services to those affected by the catastrophe.  Zanmi Lasante has helped to get the government-owned General Hospital in Port-au-Prince running again by working side-by-side with the existing medical staff and channeling important donated materials and staff to the places where they are needed.  And we have committed, for the long-term, to improving and expanding the services that this public hospital provides.  We have set up mobile medical clinics to provide services to those living on the streets in Port-au-Prince.  And we have treated many people who fled the city for the countryside in our hospitals in the Central Plateau and lower Artibonite.

Our work has been assisted by the massive outpouring of support and solidarity from people around the world and from the contributions of donor countries.

However, I can tell you that—based on our experience—the international community’s efforts could have unintended consequences, failing to truly improve the ability of Haitians to realize their fundamental rights, and in some cases, harming already vulnerable communities.

It is easy for international assistance to bypass the government and create parallel structures for social services.  We have seen this time and again in the healthcare sector, where private clinics once run by NGOs stand empty when the funding dries up and the NGO leaves the country.  The Haitian doctors, nurses and other staff members who worked in these clinics with higher than average, albeit insufficient, salaries struggle to find work.  These parallel structures not only take scarce human resources from the indigenous Haitian institutions, but they also present serious issues of accountability because they are not accountable to Haitians. I represent a non-governmental organization.  NGOs are our partners and our friends and we have a key role to play in strengthening and complementing Haitian infrastructure.  But implementation must be done through partnerships with the public sector.

Let me give you one more cautionary example: food aid.  This lifesaving assistance has plainly saved the lives of severely malnourished Haitians in the aftermath of the earthquake.  However, food aid has also been known to displace Haitian food producers and merchants, and has often been lacking in quality and cultural acceptability.  Large imports of food aid from abroad, if not coupled with support to rural communities and their agricultural needs, lead to rising food prices.  This is all the more urgent today as the time for planting and the rainy season are upon us.  Emergency food aid is a necessity, but over time, food security must be obtained by supporting Haitians’ sustainable access to durable food sources.  This means that the international community should fund agricultural infrastructure and support for rural communities.  The right to food means the right to both procure and produce adequate food; taking a rights-based approach means that the international community must do more than donate food.

As Haitians, we are proud and grateful for the solidarity of OAS Member States, but we need Haitians to lead the rebuilding.  And we need our partners to take a rights-based approach to engaging in the construction of a new Haiti. This means supporting the capacity and the leadership of both the Haitian government and Haitian communities; it means deferring to the experience of Haitians; and it means unconditionally respecting all of our human rights—including the right to food, the right to health, and the right to potable water.

World TB Day is March 24. This annual event provides an opportunity to communicate TB-related problems and solutions and to support worldwide TB-control efforts.

The following slideshow shows our TB projects and patients at the communities we serve around the world.

Watch in full screen with captions.

Participants at the Urban Walk for Haiti in 2007.

A three-mile walk through the streets of Cambridge, MA, on Saturday, March 27, will help change the lives for school children displaced by the January 12 earthquake. This year’s 7th annual Urban Walk for Haiti is dedicated to raising money for primary and secondary students at the Ecole Bon Sauveur school in Cange, which is located at a medical facility operated by PIH and and Zanmi Lasante (ZL), PIH’s partner organization in Haiti.

“The [annual cost] of providing tuition, uniforms, books, and one meal a day for one student is $300-$350, something that one walker could raise and feel proud about,” says Walk committee member Karen Fritsche. “Since the Walk has many students and teachers who are walking, the goal of education was appealing to them.”

Organized by a group of high school students, community activists, and now in partnership with Cambridge Mayor’s office and the Councilors of the City, the Walk brings awareness of the desperate situation faced by millions of Haitians forced to live with homelessness, hunger pains, HIV/AIDS, malaria, unsanitary water supplies, and other dire circumstances caused by poverty. In light of the January 12 earthquake—a devastating event that left 230,000 people dead, 300,000 injured, and 1.3 million people homeless, Haiti needs support from the international community now more than ever before.

“[Haiti’s] people are determined…to see their country rise up from past tragedies, including the devastation of the earthquake,” says Gerald McElroy, a member of the Walk committee. “The Walk is meant to harness the energy of countless activists, students, and others and use it to encourage everyone to think more critically about what's going on in the world and to take action on a local level to effectuate lasting change.”

Students lining up for class in Cange, Haiti.

“We have an abundance of resources at our disposal, and can easily serve as ‘living links’ between the developed and the developing world. In the few minutes time it takes to send an email to a friend about the Walk, you can provide necessary resources for Haitian children, including the tuition they need to attend school for a year.”

The organizers are planning to have a strong presence from the Haitian community at the walk, as well as Haitian food, crafts, dancing, and music—including the all-female Haitian music ensemble, ZiliMisik. PIH Medical Director Joia Mukherjee will also speak at the event.

Speaking of last year’s event, McElroy says: “Dr. Joia Mukerjee's speech was energizing and a perfect way to start the Walk. Hearing her once again combine Haiti's history as a country of liberty for all and tying Haiti's lack of economic progress to the strictures set upon Haiti by outsiders, in particular, was inspiring to walkers.”

“Haitians already have hope—they've been hopeful and determined for centuries; we aspire to instill that same sense of hope in those who attend the Walk,” added McElroy.

Since its inception, the Walk has helped equip operating rooms, provide community health education and schooling—including scholarships for over 800 students, supply medicine, construct reliable shelter, improve and expand water/food programs, and raise the standard of living for thousands of Haitians. Over the course of the last six years, the Walk has raised $250,000.

The Urban Walk for Haiti is hoping to raise an additional $60,000 this year.

The Walk begins on Saturday, March 27, at noon at 29 Mt Auburn St. in Cambridge. For more information, please visit walkforhaiti.org.

Get ideas for organizing your own event to support social justice, health care, and the work of PIH.

March 22 is World Water Day. Watch a slideshow of how water affects our patients, and the projects we are undertaking to provide clean, safe water to the communities we serve around the world.

Watch in full screen with captions.

Amanda Schwartz from PIH’s Boston office recently returned from a trip to Haiti with charity: water. To commemorate World Water Day – March 22 – read a post about her trip below.

Children collecting water at one of the communities visited by Amanda and charity: water.

When I went to Haiti last month with the team from charity: water, I knew that I would see a changed Haiti, one much different from the country we had visited last year. Indeed, we became witnesses to a kind of misery that is new to Haiti – already the poorest country in the western hemisphere – the kind of misery that lives in buildings turned to rubble turned to tombs, and the kind that lives in hundreds of thousands of Haitians who have lost everything. It was desperately hard to look away from the areas where hundreds of thousands of Haitians are now living under patchwork covers of sheets and tarps, knowing that the rains were on their way. It was even harder to know that there were hundreds of these camps tucked within the broken city, all in need of access to very basic rights (food, water, medicine, dignity).

Haitians have lacked access to the very basic right to clean water long before the January 12 earthquake. It was this need that first brought charity: water, a New York City-based nonprofit, together with Partners In Health (PIH) and our Haitian sister organization Zanmi Lasante (ZL), in a partnership to build community water projects. Over the past two years, our partnership has improved access to clean water for over 20,000 people in some of the poorest and hardest-to-reach communities in the Central Plateau of Haiti by providing latrines and household and community-level water.

Following the earthquake, charity: water knew that Haiti needed their support more than ever. So in February, we trekked out to eight more communities in desperate need of improved access to potable water. In some cases, these particular communities have grown tremendously in population--since the earthquake, the average household size in these areas has grown from seven people to ten people. Over the next year, PIH and ZL will be expanding our water and sanitation program by implementing projects in these eight communities--nearly triple what we have historically completed in a given year. We are deeply grateful that charity: water is helping us to do this.

While the charity: water team and I returned to the U.S. having witnessed a new kind of misery in Haiti, we also returned convinced that there is a new kind of hope there too. It is this new kind of hope that is enabling PIH and ZL to help the Haitian government build back better, and it is this kind of hope that is allowing us to grow the programs that are delivering access to basic rights that have long been needed. Today is World Water Day – a day dedicated to promoting awareness about the global need for improved access to potable water. To celebrate, charity: water is launching their Unshaken Haiti Campaign in order to raise the funds to support Partners In Health. They are launching their campaign with a special video, and will be showcasing the communities that we visited.

Watch the story of Haiti today: the story of hope:

Unshaken - charity: water's campaign for Haiti from charity: water on Vimeo.

Many organizations, including PIH, have been advocating for full forgiveness of Haiti's debt to foreign creditors. While a step forward in helping Haiti rebuild after the recent earthquake, journalist Naomi Klein argues that this debt cancellation is not nearly enough. In a recent article in The Nation, she succinctly outlines how it should be Haiti, not "the West," who should be the creditors as opposed to the debtors.

"Our debt to Haiti stems from four main sources: slavery, the U.S. occupation, dictatorship and climate change," writes Klein. "These claims are not fantastical, nor are they merely rhetorical. They rest on multiple violations of legal norms and agreements." Read more.

Klein also stresses that in disasters such as the recent earthquake, the debt repayments Haiti has been forced to pay have become truly devastating. "Each payment to a foreign creditor was money not spent on a road, a school, an electrical line."

Read the article in The Nation.

The PBS series FRONTLINE airs The Quake tonight at 9:00 pm in most locations (check your local listings). This episode investigates the efforts of those responsible for handling the catastrophic January 12 earthquake in Haiti. Correspondent Martin Smith bears witness to the unprecedented scale of the disaster and takes viewers on a searing and intimate journey into Port-au-Princes’ spontaneous settlements, hospitals, and broken neighborhoods in this hour-long documentary.

The Quake questions Haiti’s prospects for real change during this pivotal period, drawing on interviews from a number of experts, including PIH co-founder Paul Farmer; Louise Ivers, PIH’s Clinical Director for Haiti; and PIH physician David Walton.

“This is an opportunity to rethink how aid works and how we, the most powerful country in this part of the world, can work with our oldest neighbor,” said Dr. Farmer. “So I think all that possibility is build into this tragedy.”

More information about The Quake.

Watch a preview on the player below:

What's the best way to rebuild Haiti following the earthquake? A recent report by Al Jazeera English focuses on this question and challenges models of development based on production of textiles for sale in the U.S. The report features interviews with Haitian economists, farmers and community leaders who propose investing in agriculture and other industries that serve the domestic market and the needs of the Haitian people. The segment also includes interviews with PIH physicians Maxi Raymonville and Evan Lyon (starting around minute 18:45) and highlights PIH's success in providing economic opportunities as well as quality health care.

Students peforming in "RISD: The Musical!"  © James Dempsey

The Students For Haiti Challenge called upon college and university students to raise $50,000 for PIH in just one week.

To raise the stakes, the Entrepreneurs Foundation HelpHaiti Fund would match the students’ donations dollar for dollar for seven days, or until the challenge total reached $100,000 — whichever came first.

From February 22-28, participants from over 50 schools gave it the old college try. And how! From cupcake sales to weightlifting contests, we were blown away by the results—the students met the goal in just 5 days. By the end of the week, they had raised $110,682—for a grand total of $160,682! Read how some of the leading student groups met the challenge.

Bowdoin College, Brunswick, ME

Alain Mathieu '12 and Kyle Dempsey '11 co-organized Haiti Action Week by recruiting a mix of student leaders. "To have any sort of community response we needed to...tap into all of these different groups," Dempsey explained. Unsurprisingly, an interesting variety of groups led to an interesting variety of events.

One such event was the Charity Bench Press--75 entrants flexed their muscles to compete for awards, including “Best Effort” and “Most Spirited.” The event owed its success to carefully planning around the participating students’ schedules, as well as their naturally competitive spirit. "[Most of the entrants] would have been in the gym anyway and were more than happy to...show off what they can do," said Mathieu. 

Other events included the Community Ice Skate, where Bowdoin Students and Brunswick residents circled the rink to Haitian music, raising $600 through admission; and the Taste For Change Dinner, which served a Haitian meal of fried plantains and poisson (fish) for a suggested $10 donation.

Bowdoin’s Haiti Action Week raised over $9,000 for PIH—over $18,000 including the match.

Rhode Island School of Design (RISD), Providence, RI  

Premiering with back-to-back sellouts, RISD: The Musical! parodied the RISD experience "from application to graduation — all in one hour", wrote producers Greg Kozatek '10 and Jean Kim '10. The student project raised $9,000 for PIH in two nights.

Cast member Andreas Nicholas '13 framed the event as a fundraiser, and spoke about PIH after each performance. "The musical is going to be talked about for a long time this year,” said Nicholas. “And with that, Partners In Health [will be] talked about."

RISD administration covered production costs, so all ticket proceeds went to PIH. In addition, students from "The Two-Legged Print" — a course that explores the T-shirt format — sold custom-made Haiti T-shirts in the lobby. For refreshments, students sold cupcakes through RISD dining services' "Cakes For Quakes" initiative.

Now, Nicholas says, "the buzz is huge [on campus]" and students look to apply their art and design skills to Haiti relief. Check out more examples here. 

University of Colorado (CU), Boulder, CO

Beyond sponsoring bake sales and improv shows, the student group CU Stands With Haiti harnessed the CU Buffaloes' competitive spirit. For example, the students took their cause viral during the "Half Hour for Haiti," racing to send over 3,200 personal donation requests. Future events may include a "Battle of the Bands" and a video game tournament.

The Students for Haiti Challenge also helped make a final push towards the school’s own goal to raise $100,000 to benefit PIH and several Colorado-based organizations working in Haiti. Student organizer Mark Arnoldy ‘10, pins their success on "incredible support from our administration that allowed us to work throughout all departments and levels of the campus."

CU  Stands With Haiti raised about $12,000 for the challenge.

Middlebury College, Middlebury, VT

Facing the Students for Haiti Challenge with no major events on the docket, Middlebury College improvised. At the library each night, members of GlobeMed — a nationwide student network — gave out "Stand With Haiti" stickers and spoke for a sustained student response.

Although Middlebury's GlobeMed chapter focuses on projects in Uganda, it has extended advocacy and fundraising efforts to Haiti. "As a global health organization on this campus, it's important for us to focus on current events as well," said co-president Hannah Burnett '10.

Earlier in February, co-president Ben Zorach '10 convinced Kaplan, the test prep company,  to donate one of their most popular courses—worth $1,300—to be auctioned off for PIH. After a $770 bid took the prize, Kaplan chipped in another $770.

See fundraising totals for these schools and more at http://act.pih.org/page/content/university.

Earlier this month, a team of nurses from PIH’s partner organization in Peru, Socios En Salud (SES), traveled to Haiti to assist with Partners In Health/Zanmi Lasante’s (PIH/ZL) disaster relief efforts.

“As part of the PIH family, we feel special ties to our colleagues in Haiti and hope we can support them in any way we can,” said SES International Project Coordinator Elna Osso, who is leading the group. “We have the full support of our director, Dr Jaime Bayona and the entire SES team, ” added Osso. 

The SES nurses poses a wealth of skills to offer PIH’s team in Haiti, including: post operative care, medical-surgical nursing, intermediate and critical care, and TB/HIV care. In addition, Osso has 19 years of clinical experience. Another one of the SES team’s nurses worked with PIH/SES since the early 1990s. As she notes, the team’s skills would help support the post-operative needs that will be arising now that the vast majority of emergency surgeries and amputations have been completed.

“Independently we have served in disaster zones but not in the magnitude of what has happened in Haiti,” said Osso. “Two years ago there was a 7.9 earthquake south of Lima where the SES nurses served. I have worked in rural areas in Haiti and Mexico, Guatemala and Mozambique.”

SES, Partners In Health’s sister organization in Carabayllo, Peru, offers healthcare to an estimated annual population of 700,000 Peruvians. The majority of those people live in the countryside north of Lima, the country’s capital. SES’s work focuses heavily on the prevention and treatment of drug-resistant tuberculosis and HIV. In addition, the organization works closely with the Peruvian Government to provide important training and support to help implement HIV/TB policies throughout the country. SES was formed in 1994.

Osso and the SES team will be returning from Haiti later this week.

Partners In Health (PIH) commends the Obama Administration on the newly introduced Global Health Initiative (GHI), a six-year $63 billion effort that aims to improve health systems and maintain successful prevention and treatment programs in HIV, tuberculosis (TB), and malaria. The GHI also increases funds for treating neglected tropical diseases in developing countries and will have a particular focus on improving newborn, child and women’s health.

During an era of government belt-tightening that has seen a freeze in most discretionary spending, the modest increase in international health programs is a welcome sign from the White House.  Hunger and infectious disease do not ease up during down markets. In fact, economic hardship forces more families into poverty, increasing their vulnerability to disease and malnutrition.

The GHI will be included in the $9.6 billion for global health funding that the Administration recently announced for fiscal year 2011 (which spans July 2010 to June 2011).  The White House’s pledge includes a 9 percent increase in global health spending through the State Department, the U.S. Agency for International Development, the Department of Health and Human Services, and the Department of Defense.  The vast majority of this funding (about $7 billion) will go to the President’s Emergency Plan for AIDS Relief (PEPFAR), a figure that includes a $1.05 billion contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM).

However, while the 2011 funding may seem to be a step forward, in the 2008 reauthorization of PEPFAR, Congress actually included funding levels much higher than what is currently requested. For instance, in HIV/AIDS funding, this 2008 legislation authorized about $2 billion more for 2011 than what is included in the President’s current budget. And the GFATM contribution, while over $1 billion, is still $50 million less than what was appropriated in fiscal year 2010.  Both PEPFAR and GFATM funding are critical to PIH program success in providing TB and HIV treatment and strengthening public health systems.

President Obama’s commitment to the GHI is a step in the right direction, but more needs to be done. For example, the GHI lowers the target for expanding TB treatment while increasing the number of years to achieve it. The target for multi-drug resistant TB treatment—only 57,200 patients over 6 years—is astoundingly low given that 500,000 new cases are detected each year.  The bold targets for reducing neonatal, child, and maternal mortality in the GHI have been long awaited and are welcome in the face of decades of neglect, especially in reducing maternal deaths. However, the methods for achieving these reductions are not clear in the GHI. Fiscal year 2011 funding requests do not match the amounts needed to meet these targets.

With the introduction of the GHI and increased global health funding request, President Obama clearly recognizes that we cannot rest in the global health fight; as does Congress. We applaud the efforts of U.S. leadership and encourage them to continue to do far more to address the global disparities in health.

PIH worked closely with several other organizations to develop a complete response to the Global Health Initiative. Download the PDF file to read the response in its entirety.

MTV recently met up with PIH's Haiti Procurement Manager Jon Lascher in Haiti to see how donations from the "Hope for Haiti Now" telethon are being used.

Get More: Jessica Simpson, MTV Shows

The ability of Zanmi Lasante--PIH's partner organization in Haiti--to effectively take action on the ground immediately following the recent earthquake speaks to over 20 years of work building up medical infrastructure, comprehensive programs, and partnerships within local communities. Which is exactly what Abwenzi Pa Za Umoyo (APZU)--PIH's partner organization in Malawi--is now working to achieve, with some help from Zanmi Lasante.

On March 13, 2010, watch a piece about APZU's work on Alvin’s Guide to Good Business on BBC World. Featuring an interview with former Zanmi Lasante physician Jonas Rigodon, who has traveled from Haiti to help lead APZU. The interview highlights the shared philosophy and programming of PIH's projects in Haiti, Malawi, and other sites around the world.

The segment will also focus on one of the APZU programs directly modeled after a Zanmi Lasante initiative--the Program on Social and Economic Rights (POSER), which works to address the poverty affecting so many of our patients. Replacing crumbling mud huts with modest but solid houses with cement floors and metal roofs; ensuring that children have the needed supplies and school fees to attend school; and providing job training and employment opportunities to help patients pull themselves out of poverty, are just some of the projects organized by POSER.

Alvin's Guide to Good Business, produced by RockhopperTV, follows finance guru Alvin Hall as he visits a different social entrepreneur each week, probing their business model, examining the potential impact of their work, and exploring the challenges to scaling their innovation.

The episode airs on BBC World in the U.S. and internationally. 

Alvin's Guide to Good Business, produced by RockhopperTV, follows finance guru Alvin Hall as he visits a different social entrepreneur each week, probing their business model, examining the potential impact of their work, and exploring the challenges to scaling their innovation.

Read more about APZU.

The Hope for Haiti Now telethon raised millions of dollars for earthquake relief efforts, a portion of which was donated to PIH's programs in Haiti.

Watch a MTV News feature following a shipment of medical supplies, purchased with donations from the telethon, as they travel from Miami to Port-au-Prince to a PIH hospital, and into the operating room. 

Read more about these donations on MTV's site.

Naomi Rosenberg with one of the patients at a hospital Philadelphia.

“When things happen, you show up,” said Naomi Rosenberg in an article in today’s Philadelphia Inquirer. Following the Haiti earthquake, the second-year medical student at the University of Pennsylvania and former assistant to PIH co-founder Paul Farmer did far more than just show up—she put her education on hold to help save the lives of seven Haitians critically injured by the January 12 earthquake. All of the patients—three women and four children—needed medical treatment not available in their devastated country.

Naomi quickly found Philadelphia-area hospitals willing to treat the patients for free, helped to coordinate transportation, obtain the temporary immigration permission needed to medevac the patients from Port-au-Prince into the U.S., and helped to mobilize a community in Philadelphia to welcome the patients and support them while they recouperate. Naomi is currently still helping to guide the patients through their recovery and rehabilitation.

Read the inspiring story.

Dear Friends,

Nearly two months ago today, an enormous earthquake in Port-au-Prince, Haiti took the lives of more than 230,000 men, women, and children. All of the government buildings were destroyed, in addition to many homes, national landmarks and historic treasures. Amid the chaos of the physical destruction, we have witnessed many acts of courage, generosity and cooperation. The response from around the world has been heartening, and we have been privileged to work with many wonderful partners.

But we know that public attention won’t stay on Haiti for long, as new stories and new causes take over the headlines.

Partners In Health is committed to standing with Haiti now and in the months and years to come, in the communities that have long been our home and in the capital city now working to rebuild itself.

Please accept my and all of our thanks for your support of Partners In Health and of the Haitian people. And please join us as we continue to Stand With Haiti.

Click here to add your name to the STAND WITH HAITI campaign—our public call to keep Haiti at the forefront of the world's attention.

Gratefully,

Paul Farmer
Co-founder, Partners In Health

Parc Jean Marie Vincent settlement

Women with young children living in stressful environments—like those living in the temporary settlement camps in and around Port-au-Prince—are often more vulnerable to violence and disease. And Partners In Health (PIH) staff working in Port-au-Prince have reported poor conditions for women in these camps. 

To address these issues, PIH and its partner organization Zanmi Lasante are strengthening its women’s health service program at clinics serving four of these settlements, which are now home to thousands of homeless earthquake survivors.

Last week, PIH/ZL staff met with members of the women’s committee in the Parc Jean Marie Vincent, the largest of the settlement communities. The community members reported several cases of rape in the camp, and feared for their physical security after dark. The women also asked for more information about emergency contraception, post-rape STI exams and treatment, as well as family planning services, prophylaxis, breast-feeding, and infant care.

Hearing these concerns, PIH’s women’s health services program is working to strengthen and reinforce services. Rape kits and exams and prophylaxis are also available, and these services will be coordinated with PIH’s psychosocial team.  All mobile clinic staff will also be attending “refresher” trainings in women’s health basics--particularly the use of emergency contraception and management of victims of rape.  And community health workers  selected by the community committee are being trained to identify and work with at-risk women.

The team is also working to reinforce services for including family planning, sexually transmitted infection (STI) diagnosis and treatment, and services for women with young children. The team is also working to provide all women seeking obstetric care access to skilled medical care, including access to c-sections, and prenatal care and education.

Additionally, PIH/ZL and  UNICEF are providing tents where mothers with infants will have access to infant care support and education; and a clean, safe, and supportive space to breastfeed their infants.

PIH’s clinics at the settlements will continue to involve local community leaders to address security and violence issues in the camps, as well as some of the underlying factors that lead to these issues--lack of shelter, clean water, sanitation, and lighting. The mobile clinic team is working closely with other NGOs to support a cohesive system of referral for all patients requiring hospital based care, including pregnant women and their babies.

By responding to their needs, PIH/ZL will be able to combat some of the health and safety issues confronting the women living in the displacement camps. This week’s emphasis on strengthening the women’s health services program is especially fitting considering that yesterday, March 8, 2010, was International Women’s Day.

To commemorate the day, the PIH/ZL clinics, in collaboration with the camp’s women’s committee, hosted a celebration, which included discussions about women’s rights, educational sessions, music, and dancing.

Regions where PIH Russia now has MDR-TB programs.

Just south of Siberia, where PIH Russia has been combating tuberculosis for over a decade, lies another country with one of the highest rates of drug-resistant tuberculosis in the world—Kazakhstan.

PIH recently began a new program in partnership with the Government of Kazakhstan to help address this epidemic  of multidrug-resistant tuberculosis (MDR-TB).

Kazakhstan, the ninth largest country in the world and a population of 16 million people, suffers from about 20,000 new cases of TB each year, according to the World Health Organization.  About 20 percent of all new TB cases detected in the large Central Asian country are MDR-TB, meaning that these patients are infected with dangerous strains of TB that cannot be cured by the most common first-line drugs used for treating the disease.

“The problem of TB became critical in Kazakhstan, as in the rest of the former Soviet countries, after the socio-economical devastation of 1990s, which resulted in the emergence of its drug-resistant strains, especially in prisons,” said Dr. Askar Yedilbayev, PIH’s Program Director for Kazakhstan. “Kazakhstan estimates around 7,000 MDR-TB cases and only 25 percent of them currently receiving adequate treatment.”

Since 1998, PIH Russia has been curing MDR-TB patients in Tomsk, Siberia.  With a track record of successfully treating the disease in both prison and civilian populations, PIH Russia has also trained clinicians from every region in Russia, and from 10 countries of the former Soviet Union.  The new program in Kazakhstan is PIH Russia’s first formal international partnership that will include more than basic technical training and assistance.

MDR-TB is notoriously hard to treat, as patients must endure a more intensive—and expensive—second-line drug regimen, which usually requires a 2 years of drugs that carry debilitating side effects. Strains of the disease that cannot be treated by either first-line or second-line drugs are referred to as extensively drug-resistant TB (XDR-TB). About 10 percent of the 7,000 MDR-TB cases in Kazakhstan are XDR, said Dr. Yedilbayev.

PIH Russia—along with other PIH-affiliated MDR-TB programs around the world—has been so successful in treating the disease because of its reliance on community health workers to help support patients during the difficult drug regimen. These local workers help patients stay on the drug regimen and make sure that they are able to access the comprehensive services offered by our programs (including medical care as well as food, housing, and emotional support).

Other components key to successful programs  include improving diagnostics in order to detect cases earlier, developing a comprehensive strategy to promote adherence among patients, improving infection control in hospitals and clinics and decreasing transmission of TB to HIV-positive patients.

The Kazakh program will begin in the northeastern Pavlodar region (which borders Siberia), and the central Karaganda region of Kazakhstan.

“Through the implementation of PIH activities in Kazakhstan, medical professionals from two regions of the country will be trained on management and clinical aspects of MDR-TB treatment," said Dr. Alex Golubkov, Medical Director for Russia and Kazakhstan. Plans for the Kazakh partnership include: extensive training on management, clinical, and laboratory aspects of running an effective MDR-TB treatment program; helping to monitor and evaluate treatment programs; and helping to implement a comprehensive program for supporting MDR-TB patients to help ensure treatment adherence.

"PIH's work in Kazakhstan will result in increasing the number of MDR-TB patients provided with appropriate treatment and will increase quality of treatment provided," said Dr. Golubkov. "Moreover, we expect that through the fast scale-up of the MDR-TB program in Pavlodar and Karaganda the level of drug-resistant TB will be reduced and many lives will be saved”

[published March 2010]

Loune Viaud of Zanmi Lasante (PIH’s partner organization in Haiti) co-authored an op-ed in today's Boston Globe with Monika Kalra Varma, director of the Robert F. Kennedy Center for Human Rights. The piece focuses on the need for Haitian voices in decisions made to help rebuild their country.

“The solution is simple, practical, and driven by human rights,” write Viaud and Varma. “Representatives of donor states, government agencies, NGOs, and international organizations should meet with Haitians to discuss their communities’ needs, be it a water source, a school, a road or health center, and then determine specifics like where it should be constructed, how it will be maintained and when it will be completed so communities know what to expect before breaking ground.” Moreover, Haitians need to have some form of recourse if promised projects do not materialize. Read the op-ed.

Today marks International Women's Day, a global day celebrating the economic, political, and social achievements of women past, present, and future.

Commemorate the day by watching a slideshow featuring women from PIH projects around the world:

Watch in full screen with captions

The enduring ramifications of the earthquake in Haiti, already the poorest country in the Western Hemisphere, are staggering. As the initial period of crisis in Haiti ends, the long-term work of rebuilding must begin.

"While this rebuilding creates unprecedented challenges, it also provides opportunities for real change," said PIH co-founder and Harvard Medical School professor Paul Farmer, speaking to a packed auditorium at Harvard Medical School last month. "Might addressing the acute needs of the displaced and injured afford us a chance to address the underlying chronic condition?” he asked. After some reflection, he suggested, "So the diagnosis is: natural disaster in a setting of great and longstanding privation... Haiti needs to build back better and stronger than before. This, then, should be the treatment plan."

To support this ambitious goal, PIH has launched the STAND WITH HAITI Fund in Haiti to support a three-year recovery and rebuilding plan. PIH is already moving beyond the acute phase of response in order to formulate and execute medium and long-term plans for the rebuilding of lives and livelihoods, communities, and the public health system. Although these strategies are sure to evolve over time, Haiti’s need for sustained support is already here.

Read the details of this plan, including initiatives planned for the next six months, and for the next three years.

With thousands of survivors needing amputations to save their lives following the January 12 earthquake, the PIH/Zanmi Lasante team has been increasingly concerned with how to help amputee patients literally get back on their feet.

A partnership with Hôpital Albert Schweitzer (HAS) is starting to fit these patients with prosthetic devices. With a well-stocked factory in partnership with prosthetics manufacturer Hanger, HAS has already begun accepting patients referred by PIH/ZL from the Central Plateau and Artibonite regions.

Earlier this week, the PIH/ZL team brought three patients with lower extremity amputations to HAS for their prosthetic fitting. Staff noted the immediate change in the women as soon as they received their new legs--they were each able to stand up and walk with the aid of parallel bars, and quickly left behind their fears, prejudices, and doubts with each determined step. PIH/ZL staff also report that the three women are now able to walk as well as kick soccer balls. Next up on their agenda: dancing!

Janell Jones and Janna Johnson

When college student Janna Johnson started her blog Feed Your Pig as a freshman in February 2009, she could not have imagined the impact her site would have just one year later. With help from colleagues, she has transformed what had been a blog about frugal college living into a tremendous effort aimed at raising money and awareness for Partners In Health’s STAND WITH HAITI campaign.

“After hearing about the earthquake, I thought it would be great if we could do something to help Partners In Health (PIH),” says Johnson. Her friend Janell Jones and former instructor Lauren Haas agreed.

Their solution: the Buckeyes for Haiti Solace Auction (BHSA).

Johnson and Jones, friends and fellow social work majors at The Ohio State University (OSU), read Tracy Kidder’s Mountains Beyond Mountains in Haas’s Social Work Survey course. Both students were deeply moved by Kidder’s book and have had Haiti in their minds ever since. The January 12 earthquake compelled them into action.

“[First,] I contacted several hundred companies…and asked them to offer products, services, and gift certificates,” says Johnson. The response was overwhelming.

Auction gifts include: multiple gift certificates from Crocs, Inc., Ecostore USA, Rubbermaid, and SKOY. The featured gift is a Columbus Clippers Gift Package. The minor league baseball team’s donated package includes a Columbus Clippers baseball, baseball cap, and t-shirt, in addition to a $10 Clippers gift certificate and a “Family Pass” to any 2010 Clippers home game.

Next, Johnson revamped Feed Your Pig, turning it into an online auction site. “I have halted my typical blog fare in order to use the blog for the auction,” says Johnson.

Now, the women facilitate as donors bid on various items.

Beyond the auction, Johnson, Jones, and Haas are organizing a campus-wide student organization – Buckeyes for Haiti Solace. The university-sponsored organization will educate students about Haiti and raise funds for PIH throughout the academic year.

The auction began on February 15 and will run through 12 p.m. EST March 15.

By Liz Bird

	Diana's mother died in childbirth. APZU is working to make sure Diana will not face the same struggle as her mother.

“If you want to understand what Abwenzi Pa Za Umoyo has done,” said Veronica Kanyenda, a nurse at Neno District Hospital in Malawi, “you should know the story of the baby Diana.” She pointed out a small child sitting on a young woman’s lap in the shade of the health center’s metal roof. 

Veronica, affectionately called masiteni (mother) by junior staff, first met Diana the day after her birth in January, 2007.  Diana’s mother, Madalitso, was just 15 years old. Afraid to tell anyone of her pregnancy, she hid it, and delivered Diana behind her home. She suffered a post-partum hemorrhage—heavy bleeding that usually requires emergency medical care.   Although her family and neighbors administered traditional medicines, Madalitso died at home, leaving Diana an orphan. 

Wondering how she would feed and support the tiny baby, Diana’s young aunt brought her to Neno District Hospital, where staff from the Ministry of Health (MOH) and PIH’s sister project in Malawi Abwenzi Pa Za Umoyo (APZU), provided the newborn with medical care, and gave her family infant formula, clothes, and the on-going social support of a community health worker. 

“Without APZU, Diana would have been another statistic,” said Veronica. “She would have been an orphan in a family that lacked the means to support her. She would have died.

	Two-year-old Diana at her home.

Today, Diana is a lively, 2-and-a-half year old child who plays her cousins and chatters with her neighbors. Yet the tragic fate of Diana’s mother occurs daily in Malawi--one woman out of every 18 is at risk of dying from pregnancy or childbirth in her lifetime.  Malawi’s maternal mortality rate—a measure of deaths from pregnancy related causes—is among the highest for all developing countries.

The average woman in Malawi has five children, and almost half of these children are delivered at home. Home deliveries in rural Malawi are risky. When pregnancy complications requiring emergency obstetric care such as cesarean sections occur, health facilities with such services can be hours or even a day’s journey away.

To prevent maternal deaths, APZU is working to support a community-based model which supports women in their reproductive health choices, this in conjunction with a strong clinic and hospital-based women’s health program.  The programs are working to focus on antenatal care (as is standard in most public health programs) and on emergency obstetric care; as well as transport to a facility for women in labor, skilled attendants to perform deliveries, and blood and surgical services for when complications occur.

When Veronica first met Diana, she felt empowered by the presence of APZU’s Program on Social and Economic Rights (POSER), which enabled her to provide social support as well as clinical care.  POSER embodies PIH’s efforts to address the social determinants of health and provide the poorest patients with support such as food, transportation, jobs and agricultural inputs. Since Diana’s birth two and a half years ago, the POSER team routinely has provided her family with baby formula, food, fertilizer, soap, and charcoal to cook with.  “APZU, saved this child’s life,” Veronica asserted.

However, Veronica, herself a mother of seven, was also quick to emphasize the work left to be done—that no woman in Neno District or anywhere else should die during pregnancy or childbirth. 

	Community Health Workers at their monthly training.

In order to address maternal health, APZU in partnership with the MOH has taken steps to expand the community health worker program, which initially focused on HIV and TB care, to include other patients such as pregnant women.  APZU has also utilized traditional birth attendants to advocate for delivering babies at the health center rather than at home.  Both community health workers and traditional birth attendants are also educating women about the importance of family planning. In part because of these initiatives, Neno has become one of three districts in Malawi designated as a Safe Motherhood Focus District by Joyce Banda, the Vice President of Malawi and UN Ambassador for Safe Motherhood.

With these growing efforts, there is hope that Diana will never face her mother’s struggle herself. And day may come when Veronica will no longer have to tell the story of a small child orphaned because her mother died during childbirth.

Liz Bird worked for APZU in Neno, Malawi.

[published March 2010]

Journalist Lisa Armstrong of the Pulitzer Center recently blogged about a memorable service she attended at the Partners In Health/Zanmi Lasante medical facility in Cange. Read an excerpt below.

What sets PIH apart from many other organizations is the sense of solidarity with the community, which was evident when [PIH Medical Director Dr. Joia Mukherjee] and [PIH co-founder] Dr. Paul Farmer spoke at a church in Cange, a village two hours outside of Port-au-Prince, where Paul and Ophelia Dahl founded Zanmi Lasante in 1985. The service was held in a clinic waiting room, because the church itself was being used as a ward for those with shattered bones and unsalvageable limbs.

Watch part of of the Cange service below:

It seems odd to be so impressed by the fact that these doctors, and all the PIH staff we met, care so deeply for the people they serve because, after all, isn't that what doctors are supposed to do? But watching the PIH medical staff at the mobile clinics, at the general hospital, I was struck by their level of concern, by the fact that seeing patients was not simply about dispensing advice and medication. The doctors were engaged; they hugged, and laughed, and, most importantly, they listened. As Joia said to me one day, "This is not work, this is my life. It is not about us imparting our wisdom to the masses. If I am listening to you, and you are telling me something, you are teaching me something, there is an exchange. And that's where you have solidarity rather than charity."

There is often a distinction between doctor and patient, and that separation can only become more apparent when the doctor is American and privileged, and the patient is Haitian and poor. But for these doctors, there is no us and them. There is only we. Read Lisa's full blog post.

Watch the video of Reflections from Haiti, a keynote address by PIH co-founder Dr. Paul Farmer. The talk was part of the 2010 GlobeMed Global Health Summit.

Watch the webcast of the talk on the player below:

GlobeMed is a network of university students which partner with grassroots organizations around the world to improve the health of the impoverished. Through their involvement today, students commit to a life of leadership in global health and social justice.

The fourth annual GlobeMed Global Health Summit will bring together hundreds of students from GlobeMed chapters across the country for four days of lectures, workshops, and discussions with leading professionals in the field of global health, including world-renowned physician-anthropologist Dr. Paul Farmer. Through the theme of this year’s Summit, Ubuntu & Social Justice: Building global partnerships for a more equitable world, we will explore how connecting communities and people through partnerships secures the physical, mental and social well-being of individuals around the world and strengthens our vision for a socially just world. The Summit will build upon the lessons learned and knowledge gained from the Summits of the past three years, which have brought together over 400 students from 17 universities and global health leaders such as Stephen Lewis, Nils Daulaire, and Joia Mukherjee.

The 2010 GlobeMed Global Health Summit will take place from March 4-7 at Nortwestern University.

Dr. Farmer is the Maude and Lillian Presley Professor of Social Medicine and Chair of the Department of Global Health and Social Medicine at Harvard Medical School; Chief of the Division of Global Health Equity at Brigham and Women’s Hospital; United Nations Deputy Special Envoy for Haiti; and a co-founder of Partners In Health.

Cameraman David Chameides flew into Haiti two weeks after the earthquake. What moved him the most about his visit was not the massive destruction he witnessed, but the resilience and optimism of the people he met--Haitians who had lost everything but still maintained the strength and determination needed to rebuild the country.  "While the devastation was beyond comprehension, what I will carry with me are not the memories of fallen buildings, but those of a proud and noble people who refuse to bow in the face of extreme adversity," he said in creating the video below.

In his blog, he also writes:

The images in this video were taken during a trip to Haiti after the 2010 earthquake. While I would suggest donating to the organization Partners In Health if you would like to lend aid, the video is in no way endorsed by the organization and I am not connected with them in an official capacity. Partners In Health has been doing amazing work in Haiti for 25 years and will be instrumental in the country's plan for the future.

The music is from the show Glee and while unauthorized, my hope is that they will be cool with me using their material. I used it because their albums got me through some very tough nights while I was in Haiti. The lyrics, while not meant to be literal, symbolize my hope that a better future awaits the people I met there.

Enjoy and keep the people of Haiti in your hearts and minds as they will need our support for years to come.

Haiti 2010 from Sustainable Dave on Vimeo

Like never before, new technology and the internet have allowed people to connect and mobilize in support of Haiti’s earthquake survivors. From viral videos to text message donations to social networking sites, a new internet-driven movement of concerned citizens is helping keep the focus on Haiti over one month after the disaster.

One such initiative is Avaaz.org, which has rallied its members in support of the work of Partners In Health (PIH) and other local organizations working to provide life-saving food, shelter and medical care for thousands of people. In the last month, more than 19,000 of its members have donated over $1.3 million USD for relief and recovery in Haiti. 

The support directed to PIH and Zanmi Lasante (ZL, our sister organization in Haiti) from Avaaz has allowed us to do a number of things, such as supporting local medical staff, including training and hiring community health workers; providing surgical and post-operative care to earthquake survivors; coordinating mobile clinic teams to provide health services to those in marginalized communities in Port-au-Prince and increasing capacity for long-term rehabilitation and care.

Watch a video of how Avaaz’s support has directly helped relief efforts on the ground in Haiti:

“I would really like to thank Avaaz, who really supported us through this moment,” said Dr. Maxi Raymonville, ZL Director of Women’s Health. “That’s the only way we can provide this help [and] these kind of services to patients.”

Avaaz, which means “voice” in many Asian, Middle Eastern and Eastern European languages, was co-founded by Res Publica, a global civic advocacy group, and Moveon.org, an online community that pioneered internet advocacy in the United States. This global web movement has a simple democratic mission: to close the gap between the world we have and the world most people everywhere want.  The Avaaz community is served by a small team of global campaigners working in many countries to identify and develop opportunities for members to take action. After the earthquake in Haiti, Avaaz identified a small group of organizations to support in recovery efforts.  PIH/ZL was one of the organizations selected.

In addition to the donations made to earthquake relief, 450,000 Avaaz members submitted a petition to the G7 Finance Ministers to cancel Haiti’s debt.  On February 8, in response to the global outcry by individuals around the world, the G7 announced that it would move forward with the cancellation. This commitment represents over $1 billion in debt relief for Haiti.

“We need to rebuild the country and we hope that with the solidarity that [Avaaz is] giving to us we will continue and help rebuild Haiti,” said Marie-Flore Chipps, ZL Director of Nutrition, Education, Water, and Literacy Initiatives.